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Coming Soon: PECOS 2.0

CMS recently announced several updates to the online Provider Enrollment Chain and Ownership System (PECOS). Beginning this summer, PECOS will unveil the latest version, touted by CMS to make the process of applying to “become a Medicare provider...

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Industry Veteran Kit Shellhouse Joins The van Halem Group

Atlanta, GA – Kit Shellhouse, formerly of ECS North and ACU-Serve, has joined The van Halem Group, a division of VGM Group, as the Director of Business Development. With her client-focused approach and more than 20 years of experience in the...

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Kelly Grahovac Joins Big Sky Board of Directors

Atlanta, GA – The van Halem Group is excited to announce that Kelly Grahovac, General Manager, has been named as an Associate Director to the Big Sky Association of Medical Equipment Suppliers Board of Directors. “I’m honored and...

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MACs Resume Medical Review on a Post-payment Basis

Beginning August 2020, Medicare Administrative Contractors (MACs) resumed post-payment reviews of items and services with dates of service before March 2020. MACs may now begin conducting post-payment medical reviews for later dates of service. The...

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OMHA Further Expands the Settlement Conference Facilitation Parameters

By Sandra Gauron, Audit and Appeals Coordinator In an effort to provide Administrative Law Judge (ALJ) backlog relief, CMS launched the Settlement Conference Facilitation (SCF) pilot program in July 2014.  SCF is an alternative dispute resolution...

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CMS ABN form updated

CMS has updated the Advance Beneficiary Notice of Noncoverage (ABN) (Form CMS-R-131). Providers can use the new form now, and mandatory use of the form will be on 8/31/2020. The form is valid through 06/30/2023. On or after 8/31/2020, issuing an ABN...

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The van Halem Group Announces New Partnership with Össur Americas, Inc.

The van Halem Group will be partnering with Össur Americas, Inc., a global manufacturer of orthotic and prosthetic products. As part of this agreement, The van Halem Group will provide clinical prescreen reviews and appeal services for custom orthotics...

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Hospital Beds and Manual Wheelchairs added to RAC Approved Issues

CMS has approved two new topics for the DMEPOS RAC, Performant, to begin reviewing, effective March 1, 2020. Hospital Beds: Medical Necessity and Documentation Requirements Description: Hospital Beds must meet basic coverage criteria whether at...

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Medicare Documentation Job Aid for Doctors of Chiropractic

By Abrielle Uritz, RN, BSN, CPC, CEMC As a Doctor of Chiropractic, responding to a medical records request can be challenging; however, the A and B MACs have created a tool that will help to adequately respond to these requests. This includes guidance...

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Minor Claim Processing Error…… What is the next step?

By Kim Turner, RN No matter how careful, Medicare claim mistakes will happen. When they do, your claim may not be able to be processed by the DME MAC. Listed below are some common errors which prevent your claim from being processed. If you find a...

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